What monitoring is essential when using bedaquiline-containing regimens?

• A. ECG for QT prolongation and liver function tests
• B. Blood pressure monitoring only
• C. Visual acuity testing only
• D. Urinalysis

Answer: (A)

Bedaquiline carries risks of QT interval prolongation and liver injury, so the essential monitoring focuses on heart rhythm safety and liver health. The drug can lengthen the QT interval, which raises the risk of dangerous arrhythmias like torsades de pointes, especially if electrolytes such as potassium or magnesium are low or if other QT-prolonging drugs are used. That’s why an ECG is needed before starting therapy and at regular intervals during treatment to detect any QTc prolongation early. At the same time, bedaquiline can affect the liver, so liver function tests are required—baseline and periodically during therapy—to catch hepatotoxicity early. Keeping an eye on electrolytes is also important since abnormalities can worsen QT prolongation. The other monitoring options don’t address these two central safety concerns.